Permit q CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2020-00047
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/05/2020
Parcel: 2S109AA05100
Jurisdiction: Tigard
Site address: 14220 SW 128TH PL
Subdivision: ELK HORN RIDGE ESTATES Lot: 17
Project: BROOKS
Project Description: Solar photovoltaic system.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $8,000.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
i asn N
Other: Y Other Description: Roof top PV system 7.56 kW Ecom p g
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT COM VB R-3 0
Owner: Contractor:
BROOKS,CLAYTON&STEPHANIE TESLA ENERGY Required Items and Reports(Conditions)
14220 SW 128TH PL 6132 NE 112TH AVE
TIGARD,OR 97224 PORTLAND,OR 97220
PHONE: PHONE: 503-894-6903
FAX: 866-445-7459
Total Fees: $360.69
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of s or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: , _— � l%� —� Permittee Signature: ,=-
C" 5 . 39.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application ..,.
Residential AEGFIVEt FOR OFFICE t SE ONL\
City of Tigard s 2020 Date/B : •, J` Permit No.: � ;` _0
Il 1111 13125 SW Hall Blvd.,Tigard,OR 97223 Received
Plan Review
B Phone: 503.718.2439 Fax: 503.598.1960. ,. ,- �,r` Date/B : �y 4./ ��JIllll Other Permit:
IIGARI)
Inspection Line: 503.639.4175 l i I V u r 1 7 rt" Date Ready/By tans l See Page 2 for
Internet: www.tigard-or.gov -It Eo r'ylfaRI rtiNfic Nonfied/Method:, 5 Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
Ck CATEGORY OF CONSTRUCTION work indicated on this application.
1-and 2-family dwelling ❑Commercial/industrial Valuation: $ 8,000
0 Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 14220 SW 128th P1, New dwelling area: square feet
City/State/ZIP: Tigard,OR 97224,US Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Stephanie Brooks Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
PV ROOF MOUNT Valuation: $
7.56 kw Existing building area: square feet
New building area: square feet
[si PROPERTY OWNER ❑ TENANT Number of stories:
Name: Stephanie Brooks Type of construction:
Address: 14220 SW 128th PI, Occupancy groups:
City/State/ZIP: Tigard,OR 97224,US
Existing:
Phone:( 503 )840 4481 Fax:( ) New:
APPLICAN'I' E0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: TESLA (Please refer to fee schedule)
Structural plan review tee(or deposit):
Contact name: Melissa Farias
FLS plan review fee(if applicable):
Address: 6132 NE 112th Ave, Total fees due upon application:
City/State/ZIP: Portland OR 97220
A mount received:
Phone:(503 ) 894 6903 Fax::(1866)445 7459
E-mail' AFARIAS@TESL A C OM PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: TESLA Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 6132 NE 112th Ave, Solar Installation Specialty Code checklist.
Permit Fee(includes plan review $180.00 City/State/ZIP: Portland OR 97220 and administrative fees):
Phone:( 503 ) 894 6903 Fax:( 1866) 445 7459 State surcharge(12%of permit fee): $21.60
CCB lie.: 180498 Total fee due upon application: $201.60
Authorized signature: • This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Date: 1.27.20 *Fee methodology set by Tri-County Building Industry
A. Meliss arias Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Electrical Permit Applicata t •
FOR OFFICE USE O\I.l
City of Tigard N 2 8 2020 Date/B :
QPermit No.:A/-7/y P4i._O0
13125 SW Hall Blvd.,Tigard,OR 972z3' Plan Review
1 I Phone: 503.718.2439 Fax: 503.598.1960 F. /ti kA D Date/B : Other Permit:
.r d1."'.5. 4 ,�� Juris:
T I G A R D Inspection Line: 503.639.4175 „,, r Date Ready/By: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
❑New construction El Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
1'3" exceeds 10,000 amps at 150 volts or Floatingbuildings.
n TEGoi-ty Of CONSTRLI [r' :_._.. .,i ,., p ❑ g
u� �.
' "" � If
less to ground,or exceeds 14,000 Cl Commercial-use agricultural
RI 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
❑Emergency system. larger separately derived system.
1 € 't, i AND LOCATION 0 Addition of new motor load of ❑"A","E","1-2","1-3",
Job no.: Job site address: 14220 SW 128th Pl, Six or or more moes. Recreational
c anon.
❑Six or residential units. ❑Rr vehicle parks.
City/State/ZIP: Tigard,OR 97224,US 0 Health-care facilities. 0 Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: I Project name: Stephanie Brooks ❑Service or feeder 600 amps or more.
r; 17..
ow,t
Cross street/directions to job site: Description I Qty. I Fee. I Total
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.: 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential
75.00 2
(with above sq.ft.)
Limited energy,multi-family 75.00 2
PV ROOF MOUNT residential(with above sq.ft.)
7.56 kw Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
1 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: Stephanie Brooks 401 amps to 600 amps 200.34 2
Address: 14220 SW 128th P1, 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Tigard,OR 97224,US Temporary services or feeders installation,alteration,and/or
relocation
Phone:( ) I Fax:( ) 200 amps or less 59.36 I
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits—new,alteration,or extension,per panel
'" A.Fee for branch circuits with
"1 :. ",71" im '' § i 1 . t
above •service or feeder fee,
each branch circuit 7.42 2
Business name: TESLA
B.Fee for branch circuits without
Contact name: MELISSA FARIAS service or feeder fee,first 56.18 2
branch circuit
Address: 6132 NE 112TH AVE, Each add'I branch circuit 7.42 2
City/State/ZIP: PORTLAND OR 97220 Miscellaneous(service or feeder not included)
tY Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Phone:(503 ) 894 6903 Fax: :(1866) 445 7459
Reconnect only 67.84 2
E-mail AFARIAS TESLA COM Pump or irrigation circle 67.84 2
� ,,. 0" '6R ?>srg „ - . Sign or outline lighting 67.84 2
Business name: Signal circuit(s)or limited-energy See
TESLA panel,alteration,or extension. Page 2 2
Address: 6132 NE 112TH AVE, Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
City/State/ZIP: PORTLAND OR 97220 Investigation(1 hr min) 66.25/hr
Phone:( 503 ) 894 6903 Fax:(1866)445 7459 Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 180498 Electrical Lic.: C562 Suprv.Lic.: 5873S s.ecifically listed(''/hr min)
xizAt.PER
Suprv.Electrician signature,required: µc... „ Subtotal:
Print name: NICK ARMSTRONG Date: 1.27.20
��1111PPp Plan review(25%of permit fee):
_ State surcharge(12%of permit fee):
Authorized signature:-I TOTAL PERMIT FEE:
v� u This permit application expires if a permit is not obtained within 180
Print name: A.MELISSA FARIAS Date: 1.27.20 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp ELR_ERE.doc Rev 05/21/2013 4404615T(l I/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL W ORK ONLY: fE cHE
Fee for all residential systems combined $75.00 Description I Qty. 1 Fee I Total I *
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01to15kva 1 133.56 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
❑ Burglar Alarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance with 552.26 2
❑ Heating, Ventilation and Air Conditioning OAR 918-309-0040)
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
❑ Vacuum Systems* 'lOo kva-no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
ElOther: Each additional inspection is
charged at an hourly(1 hr min) 66.25/hr 1
Inspections for which no fee is 90 00/hr
specifically listed(' hi min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system $75.00 Subtotal _
(SEE OAR 918-309-0000) Plan review,if required(25%of permit fee):
State surcharge(12%of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
❑ Audio and Stereo Systems days after it has been accepted as complete.
* Number of inspections allowed per permit.
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
n F• ire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ M• edical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ O• ther
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev O5/21/2013